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CITY OF ORONO * 2 B 1 5 - 0 0 5 3 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/04/2015 <br /> , ORONO, MN 55356- <br /> ' 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3770 BAYSIDE RD <br /> PIN : OS-117-23-24-0121 <br /> LEGAL DESC : OTTOVILLE ON LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1625 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.81 <br /> CITY VIEW PLUMBING& HEATING TOTAL 50.81 <br /> 1880 WAYZATA BLVD W Payment(s) <br /> P.O. BOX 150 CHECK 35301 50.81 <br /> LONG LAKE, MN 55356 <br /> (952)473-8793 <br /> Minnesota State License#: plbg-MB005208 <br /> OWIVER <br /> STEPHENS, WINFIELD <br /> 3'170 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Sta[e Building Code. This permi[is for only the work described and does <br /> no[gran[permission for additional or related work which requires sepazate <br /> permits. AII provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked�t any time for due cause. <br /> ' ,�� <br /> .. <br /> � � � ` ��--�i �`y'"Y�l L t�� l �� �� i �S <br /> icant Perrnitee Sign ure Date Issued By Signature Date <br />